Californian Catastrophe

Posted 29th March 2018 by Dave Cross

The paper “Association of E-Cigarette Use With Smoking Cessation Among Smokers Who Plan to Quit After a Hospitalization” sought to find out if vaping worked as a quit tool. Stanton Glantz praised and promoted it, at which point things went a bit sideways. The logic of Glantz and the research team has been unpicked, laughed at and sent some unprintable images.

The research team claim they found: “Twenty-eight percent of participants used an e-cigarette within 3 months after discharge. In an analysis of 237 propensity score-matched pairs, e-cigarette users were less likely than non-users to abstain from tobacco use at 6 months.”

The paper’s authors write: “During 3 months after hospital discharge, more than a quarter of smokers attempting to quit used e-cigarettes, mostly to aid cessation, but few used them regularly. This pattern of use was associated with less tobacco abstinence at 6 months than among smokers who did not use e-cigarettes. Additional study is needed to determine whether regular use of e-cigarettes aids or hinders smoking cessation.”

This was joy to Glantz’ ears, and he called it “a well-done study”. If he was talking about how it was about to get roasted then he was on the money.

On his blog, Glantz demands to know: “How many more studies do we need before the e-cigarette enthusiasts will admit that, for most people, e-cigarettes, as actually used, make it harder (not easier) to quit smoking?”

The first flaw was quickly pointed out by @rphallisey84513: “The data is not possible though. How are they finding 8 new smokers when smoking rates continue to decline? Not to mention, their model numbers are not even possible based off population numbers.”

It got worse. Jake Jacobsen pointed out that Glantz had made an error in his understanding – by a factor of ten: “Still in need of a proof reader and now it appears his math skills need improvement! 2,070 quitters results in 168,000 additional smokers. 168000 / 2070 = 81.159420289855072. Or 80 new smokers to every one quitter! Bullshit!”

Jukka Kelovuori added: “It speaks volumes when the absolute worst modelling study ever done is what you consider to be ‘the best’. 80 (not 8) new smokers for every quitter. That'd mean UK has 120M new smokers!”

Peter Hajek, an advocate of harm reduction and tobacco expert at Queen Mary University, commented on the study: “The headline of the press release (‘e-cigarettes hamper smoking cessation’) has no relationship to the study findings. The study just shows that smokers who did not manage to stop smoking with recommended treatments may have been more likely to try e-cigarettes than those who quit successfully. This provides no information on whether ecigs help smokers quit or not. The key message is that the press release is misleading.”

His message was echoed by Professor Paul Aveyard, an expert in behavioural medicine at Oxford University: “This was a study of people trying to quit smoking while they were in hospital and trying to stay quit after discharge. It showed that those who used an e-cigarette after discharge were less likely to stop smoking at six months than those who did not use an e-cigarette.”

“There are two possible explanations: either e-cigarettes make quitting harder or there were differences between those who used an e-cigarette and those who didn’t that explain the results and this latter explanation seems more likely here. Why would someone who stopped smoking and was finding it easy to quit choose to buy an e-cigarette? On the other hand, a person who was struggling and lapsing might well choose to get extra help. There is actually data in the paper that supports this explanation.”

Glantz failed to respond to any comments pointing out the shortcoming in his ability to critically analyse research, although he did state on his blog that he genuinely believes smoking rates would be even lower without ecigs.